scholarly journals Blue LED as a new treatment to vaginal stenosis due pelvic radiotherapy: Two case reports

2021 ◽  
Vol 9 (23) ◽  
pp. 6839-6845
Author(s):  
Daniela Barros ◽  
Cecília Alvares ◽  
Teresa Alencar ◽  
Priscila Baqueiro ◽  
Augusto Marianno ◽  
...  
Keyword(s):  
Case Reports ◽  
Pelvic Radiotherapy ◽  
Blue Led ◽  
Vaginal Stenosis ◽  
New Treatment

scholarly journals Vaginal dilator therapy to prevent stenosis from radiotherapy: A systematic review

2016 ◽  
Author(s):  
Nupur Bansal ◽  
Abhishek Soni ◽  
Anil Khurana ◽  
Yashpal Verma ◽  
Paramjeet Kaur ◽  
...  
Keyword(s):  
Large Population ◽  
Good Evidence ◽  
Control Group ◽  
Cochrane Central Register ◽  
Psychological Consequences ◽  
Pelvic Radiotherapy ◽  
Inflammatory Phase ◽  
Vaginal Stenosis ◽  
Vaginal Length ◽  
Central Register

Background: Pelvic radiotherapy may damage the vagina and cause vaginal stenosis. Its incidence in the literature ranges from 1.2% to 88%. To prevent vaginal stenosis, routine vaginal dilation is recommended during and after pelvic radiotherapy. Materials and Methods: The objective was to examine critically the evidence behind this guideline. Searches included the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and Google scholarly articles. All the relevant articles were included in the study. Discussion: Various studies gave recommendations on dilation during or immediately after radiotherapy. Literature does not support routine vaginal dilatation during or immediately after pelvic radiotherapy. Occasional penetration might prevent the sides of the vagina adhering to each other, and dilation might be valuable once the inflammatory and psychological scarring has settled. Two trials demonstrated that encouraging vaginal dilation increased patient compliance, but no difference was found in sexual function scores in the first trial. One retrospective study reported that dilation lowered stenosis rates, but the control group is not comparable. One study involving 89 women revealed that the median vaginal length was 6 cm, six to ten weeks after radiation therapy, but women tolerated a 9-cm dilator/measurer after 4 months of dilation experience. One trial showed no significant advantage by inserting mitomycin C. A study of five women reported that vaginal stenosis can be treated by dilation even many years after radiotherapy. Dilation during or immediately after radiotherapy can cause damage, and there is no evidence that it prevents stenosis. Dilation might stretch the vagina if commenced after the inflammatory phase. Dilation has been associated with traumatic rectovaginal fistulae and psychological consequences. Conclusion: Vaginal dilation might help treat the late effects of radiotherapy, but it must not be assumed that this applies to the acute toxicity phase. Routine dilation during treatment is not supported by good evidence. Prophylactic and therapeutic dilation therapy needs to be considered separately and research is needed to determine when dilation therapy should start on a large population.

scholarly journals Latvian experience in conservative management of abnormally invasive placenta: two case reports

2020 ◽  
Vol 26 (3) ◽  
pp. 153-158
Author(s):  
Diana Bokučava ◽  
Sandra Vītiņa ◽  
Maira Jansone ◽  
Mara Tirāne ◽  
Zane Krastiņa ◽  
...  
Keyword(s):  
Conservative Management ◽  
Case Reports ◽  
Placental Tissue ◽  
University Hospital ◽  
Tertiary Referral Hospital ◽  
Excessive Bleeding ◽  
Section Operation ◽  
Invasive Placenta ◽  
New Treatment

Background. Abnormally invasive placentation (AIP) is a clinical term that describes situation when placenta does not separate spontaneously after delivery and its manual removal causes excessive bleeding (1). Historically, the treatment of choice for this condition is hysterectomy. Lately, the new treatment option, conservative management of the AIP, has proven itself an effective alternative to hysterectomy in carefully selected patients (2). However, the use of conservative AIP management is limited in many countries, the reasoning being the lack of doctors’ experience in this procedure and concerns regarding a high postpartum infection rate. Case reports. We present the first two cases of conservative management of AIP in Latvia. Most of prenatally diagnosed AIP cases country-wide are referred to the Paul Stradinš University Hospital, which is a tertiary referral hospital. The annual rate of AIP in the hospital varies from five to ten cases. Two pregnant women were diagnosed with AIP prenatally, both of them refused hysterectomy and therefore went for the conservative management of AIP. During Caesarean section operation, placentas were left in situ after delivery of the baby. During the follow-up period of 12 and 14 weeks, both women developed infection complications, but complete placental tissue resolution was diagnosed in the end. Conclusion. These two cases demonstrate that conservative management of AIP can be safely applied in small countries/areas with small AIP rate and management experience.

scholarly journals Creatsas modified vaginoplasty as reconstructive treatment of vaginal stenosis due to vaginal or pelvic radiotherapy

2020 ◽  
Vol 30 (8) ◽  
pp. 1249-1249
Author(s):  
Sheila Vazquez ◽  
Pablo Padilla-Iserte ◽  
Tiermes Marina ◽  
Victor Lago ◽  
Luis Matute ◽  
...  
Keyword(s):  
Pelvic Radiotherapy ◽  
Vaginal Stenosis

scholarly journals Case Reports for Topical Treatment of Corneal Ulcers with a New Matrix Therapy Agent or RGTA® in Dogs

2019 ◽  
Vol 6 (4) ◽  
pp. 103
Author(s):  
Jessica A. Martinez ◽  
Franck Chiappini ◽  
Denis Barritault
Keyword(s):  
Case Reports ◽  
Primary Treatment ◽  
Bullous Keratopathy ◽  
Eye Drops ◽  
Corneal Ulcers ◽  
New Therapeutic Approaches ◽  
Time Period ◽  
New Treatment ◽  
Ophthalmic Treatment ◽  
Ulcerative Keratitis

Superficial corneal ulcers that fail to heal within a normal time period and are refractory to conventional therapy in dogs are common in veterinary practice. Different etiologies can lead to this result, including spontaneous chronic corneal epithelial defects (SCCEDs) and ulcerative keratitis associated with bullous keratopathy. Thus, there is an urgent need to find new therapeutic approaches such as matrix therapy replacement. To determine the efficacy of a new ophthalmic treatment (Clerapliq®) for SCCEDs and ulcerative keratitis associated with bullous keratopathy, a total of 11 dogs referred to the clinic because of nonhealing erosive ulcers after a classic primary treatment were enrolled to get this new treatment. Dogs underwent ophthalmic exams and 7 dogs (10 eyes) were diagnosed with superficial ulceration and 4 dogs (5 eyes) with bullous keratopathy due to endothelial dystrophy/degeneration. They received eye drops of Clerapliq® every 3 days until recovery. The results showed that the corneas with recurrences of the ulcers were resolved predominantly by using Clerapliq® every 3 days in 83.3% of the cases during a period of treatment ranging between 6 to 35 days. Therefore, this new approach using matrix therapy regenerating technology in treating superficial ulcers and bullous keratopathy in dogs can be successfully considered as an adjunctive therapy.

scholarly journals The Involvement of Hypothalamus–Pituitary–Adrenal (HPA) Axis in Suicide Risk

2020 ◽  
Vol 10 (9) ◽  
pp. 653 ◽  
Author(s):  
Isabella Berardelli ◽  
Gianluca Serafini ◽  
Natalia Cortese ◽  
Federica Fiaschè ◽  
Rory C O’Connor ◽  
...  
Keyword(s):  
Hpa Axis ◽  
Systematic Reviews ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Case Reports ◽  
Number Of Patients ◽  
Hpa Axis Dysregulation ◽  
New Treatment ◽  
Meta Analyses ◽  
Hpa Axis Activity

Stress and Hypothalamic–Pituitary–Adrenal (HPA) axis dysregulation play a major role in various pathophysiological processes associated with both mood disorders and suicidal behavior. We conducted a systematic review with the primary aim of clarifying the nature and extent of HPA axis activity and suicidal behavior. The second aim of this review was to investigate whether potential biomarkers related to HPA axis abnormalities act as individual susceptibility factors for suicide. The PRISMA statement for reporting systematic reviews was used. Only articles published in English peer-reviewed journals were considered for possible inclusion; we excluded case reports, meta-analyses, and systematic reviews, and studies that did not clearly report statistical analysis, diagnostic criteria, or the number of patients included. Overall, 36 articles on HPA axis and suicide risk met inclusion criteria and were reviewed. Studies that investigated tests detecting biomarkers and the role of early life stressors in suicide risk were also included. We found that HPA axis activity is involved in suicide risk, regardless of the presence or absence of psychiatric conditions. The HPA axis abnormalities, mainly characterized by hyperactivity of the HPA axis, may exert an important modulatory influence on suicide risk. Impaired stress response mechanisms contribute to suicide risk. Targeting HPA axis dysregulation might represent a fruitful strategy for identifying new treatment targets and improving suicide risk prediction.

scholarly journals Spontaneous Nasal Polypectomy Proceeded by Fluticasone Propionate (XHANCE®) and Zileuton (Xyflo®) Application

2020 ◽  
Vol 1 (2) ◽  
pp. 8-12
Author(s):  
Marija Rowane ◽  
Kelsey Graven ◽  
Robert Hostoffer
Keyword(s):  
Fluticasone Propionate ◽  
Treatment Regimen ◽  
Nasal Polyposis ◽  
Case Reports ◽  
Subcutaneous Immunotherapy ◽  
Intranasal Corticosteroids ◽  
Patient Reported ◽  
Oral Corticosteroids ◽  
History Of ◽  
New Treatment

Abstract Background: Nasal polyps (NPs) are inflammatory outgrowths of paranasal sinus mucosa that occur in one to four percent of the population and most commonly cause congestion, obstruction, or hyposmia. Intranasal corticosteroids, along with short courses of oral corticosteroids, are most often recommended for symptomatic nasal polyposis, prior to consideration of surgical intervention. We present the first reported case of spontaneous nasal polypectomy, occurring after use of fluticasone propionate (XHANCE®) and zileuton (Xyflo®). Methods: A 43-year-old Asian-Indian male with history of allergic rhinitis, asthma, and nasal polyposis had been prescribed subcutaneous immunotherapy for five years without effectiveness before another polypectomy was scheduled. After the polyps resurfaced, the patient was prescribed prednisone and underwent another polypectomy. He later presented with persistent NPs and congestion, as well as diffuse lymphadenopathy and pruritic eyes and ears. Fluticasone Propionate was continued as maintenance therapy and Zileuton was prescribed in place of Montelukast (Singulair®). Results: After several weeks of the new treatment regimen, the patient reported polyp irritation and movement, as well as influenza-like symptoms. Epistaxis soon occurred, followed by a spontaneous polypectomy. Three more polyps were expelled with bloody discharge. The patient reported resolved hyposmia and reduced symptoms thereafter. The treatment regimen was continued without change or further episodes of epistaxis and polypectomy. Conclusion: Few case reports in the literature describe polyp autoamputation. We report the first instance of spontaneous nasal polypectomy in the literature, induced by Fluticasone Propionate and Zileuton.

Predictors of early vaginal stenosis during pelvic radiotherapy for locally advanced cervix cancer: a study from a tertiary cancer centre in Eastern India

2015 ◽  
Vol 14 (2) ◽  
pp. 216-218
Author(s):  
Aparna Gangopadhyay ◽  
Jaydip Biswas
Keyword(s):  
Relative Risk ◽  
Locally Advanced ◽  
Cervix Cancer ◽  
Intracavitary Brachytherapy ◽  
Optimal Timing ◽  
Pelvic Radiotherapy ◽  
Concomitant Chemotherapy ◽  
Vaginal Stenosis ◽  
Radio Therapy ◽  
Two Factors

AbstractAimTo explore possible predictors of early vaginal stenosis among patients with locally advanced cervix cancer on pelvic chemoradiation.Patients and methodsA total of 232 patients with locally advanced cervix cancer, who received pelvic radiotherapy at our institute from November 2011 to October 2013, were prospectively studied. Possible predictors chosen were age, tumour stage, initial vaginal involvement, concomitant chemotherapy and development of vaginitis of Radio Therapy Oncology Group grade 2 or more during radiotherapy. Multiple logistic regression was carried out to assess predictors and the relative risk of predictors was calculated.ResultsInitial vaginal involvement and addition of concomitant chemotherapy are predictors of early vaginal stenosis in locally advanced cervix cancer patients on pelvic chemoradiation. Relative risk for early vaginal stenosis with vaginal involvement at presentation was 16·31, whereas that for concomitant chemotherapy was 9·95.ConclusionAmong patients with locally advanced cervix cancer receiving pelvic chemoradiation, two factors, namely, initial vaginal involvement and concomitant chemotherapy are predictive of early vaginal stenosis. Patients with these factors should be assessed at regular intervals for early vaginal stenosis during pelvic chemoradiation to assess the optimal timing of intracavitary brachytherapy. This is particularly of importance in the absence of facilities for interstitial brachytherapy to ensure appropriate target coverage.

scholarly journals Vaginal Vibrator as an alternative to Dilator in vaginal stenosis post pelvic radiotherapy in cervical cancer

2021 ◽  
Vol 12 (10) ◽  
pp. 171-174
Author(s):  
Manjari Shah ◽  
Disha Tiwari
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Experimental Basis ◽  
Pelvic Radiotherapy ◽  
Pelvic Radiation ◽  
Vaginal Stenosis ◽  
Doctor Communication ◽  
Psychosexual Adjustment

Sexuality, post cancer treatment is the most unattended aspect of patient doctor communication. Quality of life in a cancer survivor should be addressed without any inhibitions so that patient does not suffer from any kind of psychological distress. Vaginal stenosis is a well-known side effect of pelvic radiotherapy, which we have tried to address in our study. We have used vaginal vibrator as an alternative to vaginal dilator in two of our patients on experimental basis post vaginal dilator. Both the patients gave feedback that vibrator is comparatively easy to use and less painful. On follow up examination visits, their per vaginal examinations were easy to perform and visibly improved vaginal mucosal health. Psychosexual adjustment is an important domain for better quality of life. Vaginal vibrator is an unorthodox method which we have explored and found some promising results, in overcoming vaginal stenosis and adhesions post pelvic radiation. However, this aspect of treatment as well as method needs to explored.

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